National Sample Of Women Research Articles

Woman-to-woman sexual violence: does she call it rape?

Woman-to-Woman Sexual Violence: Does She Call It Rape? Lori B. Girshick. Boston: Northeastern University Press. 2002. 201 pp. ISBN 1-55553-527-5. $16.95 (paper). If sexual violence is rooted in patriarchy, male dominance, and oppression of women, then how do we explain women's sexual violence? If women are nonviolent and lesbianism an egalitarian Utopia, then how do we understand women's violence against other women, especially their own partners and lovers? As Lori Girshick so ably points out, heterosexism and homophobia mean that the ways women experience sexual violence by other women are frequently not recognized as rape or sexual assault, thus depriving victims of support and services. Women-to-Woman Sexual Violence confronts the paucity of research, popular press attention (even in the queer press), and services. Sexual violence is any unwanted sexual activity and includes contact and noncontact sexual activities (p. 19). Girshick's data come from a self-administered, largely open-ended survey and follow-up interviews collecting detailed information about sexual violence incidents and their aftermath and women's understandings of sexual violence and homophobia. Participants were recruited via announcements posted throughout the United States to domestic violence and rape crisis agencies and feminist, gay, lesbian, bisexual, and transgender centers, organizations, groups, and media. The 70 women, aged 18-64 (average age 37), thus comprise a self-selected, unrepresentative, but nearly national sample of women who experienced woman-to-woman sexual violence. Most of the women were White, lesbian, and working or middle class in terms of education and occupation, though frequently not income. They described 91 situations of sexual violence, most of which occurred during or before the 1980s and when the average age of the women was under 25. The women's youth and the historical time period (the earliest years of lesbian activism), in combination with significant abuse histories for many women, made it more difficult for them to speak out and seek help. The experiences of these women are remarkably similar to those of women experiencing heterosexual violence. Most of the incidents occurred within the context of committed or romantic relationships or with acquaintances or friends. Nearly half of the incidents occurred in a battering relationship. Women frequently remained silent about their victimization, either because of the assailant's terrorizing or because of their own or their friends' disbelief. Legal assistance was seldom sought and rarely effective. In relating the incidents of sexual violence suffered by these women, Girshick makes clear that violence is not about gender but about power and control. Citing bell hooks' (1984) examination of interlocking systems of oppression and domination, she explores the ways in which heterosexism (and monosexism) and homophobia (also bi- and transphobia) collude to assist the assailant in maintaining power over her victim. …

Sexual assault history and suicidal behavior in a national sample of women.

This study examined demographic and psychosocial correlates of suicidal ideation and suicide attempts in women with histories of sexual assault in childhood and/or adulthood identified from a national sample of women. Multivariate analyses showed that women with histories of sexual assault in both childhood and adulthood reported significantly greater odds of lifetime suicide attempts, controlling for demographic factors and other psychosocial characteristics. As predicted, younger age (marginal), stressful life events (marginal), depression, PTSD, and alcohol dependence symptoms were also significantly associated with suicidal ideation. Furthermore, number of lifetime traumatic events and depression were each associated with lifetime odds of suicide attempts. Implications for studying the role of sexual trauma and other psychosocial factors in relation to women's suicidal behavior are discussed.

Sexual assault history, PTSD, and mental health service seeking in a national sample of women

AbstractThis study examined correlates of posttraumatic stress disorder (PTSD) and mental health service seeking for women sexually assaulted in childhood and/or adulthood (N = 619) identified from the National Comorbidity Survey (1990–1992). Factors related to correlates of PTSD and mental health service seeking varied according to sexual assault history. Ethnic minority women with less formal education, more traumatic and stressful life events, and longer duration of sexual abuse had greater odds of PTSD within certain sexual assault history subgroups. Mental health service seeking was predicted by demographics (e.g., more education, Caucasian race), as well as other psychosocial factors (e.g., life events, social support), and medical insurance status, especially for adult sexual assault victims. Implications for mental health treatment and intervention are drawn for women with different sexual assault histories. © 2002 Wiley Periodicals, Inc.

Adherence to antiretroviral therapy and its association with sexual behavior in a national sample of women with human immunodeficiency virus.

To delineate the relationship between adherence to human immunodeficiency virus (HIV) therapy and sexual behavior among HIV type 1-infected women in the United States, data were collected from October 1998 through March 1999 from 766 HIV-positive women on adherence to therapy, risk behavior, and disease markers. Adherence rates of >/=95% were reported by 66% of the patients. In multivariate analyses, patients with lower rates of adherence tended to be younger (odds ratio [OR], 1.69), to be active drug users (OR, 2.27), to have detectable virus load levels (OR, 2.00), and to have a lower quality of life (OR, 1.20). Among sexually active women, lower adherence rates were associated with an increased risk for inconsistent condom use (adjusted OR, 2.17). Although counseling regarding sexual behavior and adherence to treatment regimens are often addressed separately, our data highlight the importance of discussing these factors in relation to one another, particularly with regard to patients experiencing virologic failure.

Two Aspects of Fertility Behavior in South Africa

In this article we analyze two aspects of female fertility using unit record data from South Africa. We examine the effect of individual, household, and community characteristics on the age at first conception and the number of pregnancies for a national sample of women. The segmented nature of theeconomy of South Africa allows us to study differences in fertility patterns among the different socioeconomic classes and across the different races. 1 While much has been said about fertility behavior of women in sub-Saharan Africa, an analysis of the fertility patterns of South African women is significantly absent. 2 In this article we attempt to fill this gap in the literature. The first aspect of fertility behavior that we examine is the age at first conception. In addition to the significant biological components associated with the age at first conception there are economic and nonbiological factors that affect the probability of conceiving by influencing the choices that women make (including choices regarding birth control and other family-planning strategies). Age at first conception is modeled using a hazard model. Of particular importance is the effect of the highest level of education attained on the age at first conception. The estimation results show that the more educated a woman is, the higher is the age at first conception subject to a threshold level of education. There are no significant racial differences in the age at first conception. The second aspect of fertility examined is the number of times a woman has been pregnant. Economic theories of fertility assumethatparentsoptimally choose the number of children they want to have, taking into account the costs and benefits associated with a given number of births, including the costs of avoiding unwanted births. Assuming that no pregnancy is unwanted, the number of times a woman is pregnant over her reproductive age can

Predictors of medical examinations following child and adolescent rapes in a national sample of women.

Childhood rape occurs frequently in our society and is associated with adverse consequences. Despite the severity of these outcomes, there appear to be many obstacles for children to receive postrape medical care. To date, it is unclear what proportion of childhood rape victims receive postrape medical examination or what factors predict receipt of this medical care. This study instigated the factors predicting immediate medica care for women who were raped during childhood. Data for the study were obtained from the final wave of the 2-year, longitudinal National Women's Study. Results indicated that the majority of women did not receive medical care following their childhood rape. Although women raped as adolescents were more likely to receive a postrape exam, logistic regression analyses indicated that rape characteristics (e.g., reporting the assault, concerns about sexually transmitted diseases [STDs]) mediated the relationship between age of victimization and receipt of medical care. Implications of these findings are discussed.

Welfare, work experience, and economic self-sufficiency

The potential of former AFDC recipients to earn a living wage is central to the success of welfare-to-work programs. Previous studies have found that welfare recipihyphen;ents see little increase in their wages over time. Low wage growth could arise from either low returns to work experience or low levels of experience. This distinction is important for designing effective welfare policy. In the following paper, we estimate how wages grew with work experience between 1978 and 1992 for a national sample of women from the National Longitudinal Survey of Youth. We compare women who never received welfare with both short- and long-term recipients in order to see to what extent the rates of wage growth with work experience differ. We find that they differ very little. We use numerous specification checks to test the robustness of our results and find consistent evidence that the wages of AFDC recipients grew at a rate similar to those of nonrecipients once work experience is taken into account. © 2001 by the Association for Public Policy Analysis and Management.

Understanding of Sexuality and Reproductive Health Among Women With and Without Physical Disabilities

This study compares differences in how women with disabilities and women without disabilities learned about their sexuality and reproductive functioning. A written questionnaire was sent to a national sample of women with disabilities and their non-disabled woman friends recruited through independent living centers and announcements in the media. Responses were received from 504 women with disabilities and 442 women without disabilities. Participants were asked how old they were when they first learned about the physical aspects of sexual intercourse. Women with disabilities learned about the physical aspects of sexual intercourse at about the same age (M = 13.16) as women without disabilities (M = 12.93). The most commonly reported sources for learning about sexuality and sexual functioning for both groups were books and other printed material, having sex, partners, friends, and teachers in primary school. More women with disabilities received information from a woman with a disability and a rehabilitation counselor. Women in both groups indicated that sex was never or seldom the subject of general family conversation. On average the women with physical disabilities had their first date at age 16.6, which is later than women without physical disabilities (M = 14.91). Women with physical disabilities who reported having acquired sexuality information at a later age reported having sexual intercourse at an older age (M = 20.37) than women without physical disabilities (M = 17.75). Age at acquiring sexuality information was neither associated with frequency of intimate touch nor frequency of sexual intercourse. The results of this study can be used to generate recommendations for health care professionals concerning ways to respond more effectively to the special needs for sexuality information of physically disabled women.

Alcohol and adult sexual assault in a national sample of women.

Alcohol use is commonly present in sexual assault incidents, but the nature of its role in these offenses remains unclear. Researchers have argued that the propensity to abuse alcohol generally and the use of alcohol prior to assault by offenders and victims may be associated with increased severity of sexual abuse and physical injury to sexual assault victims. In particular, there is speculation that offender drinking may facilitate offenders' use of greater physical aggression against victims in their attacks, resulting in more serious injuries to victims. The role of alcohol in sexual assault incidents (n = 163) identified from a national sample of women was studied. In the present sample, offender pre-assault drinking and offender aggression used in the offense were each strong predictors of victim physical injury. Victim heavy episodic drinking did not predict victim injury controlling for other assault characteristics, victim and offender drinking prior to assault, and victim demographic characteristics. Drinking by offenders and victims was more common in assaults where victims were less well acquainted with their assailants prior to attack. Higher levels of offender aggression and victim injury were also associated with stranger attacks. Implications of the results for the study of alcohol and sexual assault are discussed.

Predictors of post-rape medical care in a national sample of women

Background: Rape has a negative impact on physical and mental health, health-related behaviors, and health service utilization. Timely medical care is important for preventive services. Methods: Cross-sectional data were obtained from a larger 2-year longitudinal study, the National Women’s Study (NWS). A total of 3006 adult women participated in the final data collection wave of the NWS. During a structured telephone interview, women who reported a most-recent or only rape incident during adulthood were asked about rape characteristics, reporting to authorities, medical care, and rape-related concerns. The main outcome measures were receipt and timing of medical care received after an adult rape, and factors influencing whether or not medical care was received. Results: Of the sample, 214 (7.1%) had experienced a most-recent or only rape as an adult (aged ≥18), and 56 (26.2%) received rape-related medical care following that incident. The final model multivariable logistic regression indicated that reporting the crime to police or other authorities (odds ratio [OR], 9.45; 95% confidence interval [CI]=3.34–26.70) and fear of sexually transmitted diseases (OR, 8.61; 95% CI=3.12–23.72) were significant predictors of receipt of post-rape medical care. Conclusions: One in five victims reported an adult rape to police or other authorities; these women were nine times more likely to receive medical care than those who did not. Public health efforts are needed to increase the proportion of rape victims who receive immediate post-rape medical care.

Oral contraceptive use and glucose metabolism in a national sample of women in the United States

Objective: This study was undertaken to determine whether users of oral contraceptives in a nationally representative population of US women had elevated levels of measures of glucose metabolism. Study Design: Cross-sectional data from the Third National Health and Nutrition Examination Survey (1988-1994) included hemoglobin A1c levels and fasting glucose, insulin, and C-peptide levels. Means were compared among those who had never used oral contraceptives, current users of oral contraceptives, and former users of oral contraceptives, with and without adjustment for potential confounders. Results: The vast majority of current users of oral contraceptives were using low-dose estrogen formulations. The two most common preparations were a triphasic formulation containing 0.035 mg ethinyl estradiol and 0.5, 0.75, and 1 mg norethindrone (23.9%) and a monophasic formulation containing 0.035 ethinyl estradiol and 1 mg norethindrone (20.7%). Current users of oral contraceptives did not have elevated values for any of the four measures of glucose metabolism. Hemoglobin A1c level and fasting glucose, insulin, and C-peptide levels were not related to duration of current use, age at which use began, or major formulation type. Among women who were former users of oral contraceptives there was no evidence of higher values among those who had recently ceased use. Conclusion: Oral contraceptive formulations currently available in the United States are not associated with an adverse glucose metabolic profile. (Am J Obstet Gynecol 2000;183:389-95.)

Longitudinal predictors of binge eating, intense dieting, and weight concerns in a national sample of women

As part of an ongoing longitudinal study of the antecedents and consequences of women's drinking in the U.S. adult female population, women who participated in a 1991 survey provided data in 1996 about their experiences of binge eating, intense dieting, and weight concerns ( N = 709, ages 26 to 54 in 1996). Five percent of the women reported binge eating in the past 30 days, 29% reported that they had engaged in intense dieting or fasting in the past 3 months, and 1.5% of the women met criteria for nonpurging bulimia nervosa (binge eating and intense dieting). Forty-three percent reported that their weight and shape were either very important or more important than anything else. After controlling for 1991 occurrence of binge eating, predictors of binge eating in 1996 were past 12-month use of illicit drugs (mostly marijuana) and greater occurrence of drinking to intoxication. A body mass index (BMI) × 1991 binge eating interaction indicated that having a higher BMI in 1991 predicted the onset of binge eating by 1996, but it did not predict the continuation (chronicity) of binge eating 5 years later. Year 1991 predictors of intense dieting in 1996 were having weight concerns, being unmarried, having used illicit drugs in the past 12 months, and having parents who had more than a high school education. Only a younger age in 1991 and having a lower BMI predicted 1996 weight concerns, after controlling for weight concerns 5 years earlier. These results indicate that risk factors for the onset and chronicity of disordered eating behaviors and attitudes across longer time periods in adult women may differ considerably from predictors found in cross-sectional studies or studies of adolescent females.

Prevalence and risk factors for childhood sexual abuse in women: national survey findings

Objective: We interviewed a U.S. national sample of women, aged 18 years and older to determine the prevalence and characteristics of childhood sexual abuse. We also examined which family and background variables were predictive of CSA in this sample. Method: The study employed a series of detailed descriptive questions regarding childhood sexual experiences that were administered in a highly structured format by trained female interviewers. CSA prevalence rates were calculated using two definitions of CSA, one of which was slightly more inclusive. Results: Prevalence rates for the more inclusive CSA definition ranged from 21% to 32%, depending on how respondents who provided incomplete information about their sexual experiences were classified. The less inclusive CSA definition resulted in prevalence rates ranging from 15% to 26%. Additional information about the types of abuse experienced, perpetrator characteristics, age at first abuse, and physical and affective consequences of the abusive experiences are reported. The risk of CSA was related to higher scores on a measure of father’s rejection, and the interaction between parental drinking status and whether the respondent had lived with both parents during childhood. Further analysis of this interaction suggests that when respondents reported living with both biological parents, they were most at risk for CSA when their father was a nondrinker and their mother was a drinker.

Rape-related pregnancy: Estimates and descriptive characteristics from a national sample of women

OBJECTIVE: We attempted to determine the national rape-related pregnancy rate and provide descriptive characteristics of pregnancies that result from rape. STUDY DESIGN: A national probability sample of 4008 adult American women took part in a 3-year longitudinal survey that assessed the prevalence and incidence of rape and related physical and mental health outcomes. RESULTS: The national rape-related pregnancy rate is 5.0% per rape among victims of reproductive age (aged 12 to 45); among adult women an estimated 32,101 pregnancies result from rape each year. Among 34 cases of rape-related pregnancy, the majority occurred among adolescents and resulted from assault by a known, often related perpetrator. Only 11.7% of these victims received immediate medical attention after the assault, and 47.1% received no medical attention related to the rape. A total 32.4% of these victims did not discover they were pregnant until they had already entered the second trimester; 32.2% opted to keep the infant whereas 50% underwent abortion and 5.9% placed the infant for adoption; an additional 11.8% had spontaneous abortion. CONCLUSIONS: Rape-related pregnancy occurs with significant frequency. It is a cause of many unwanted pregnancies and is closely linked with family and domestic violence. As we address the epidemic of unintended pregnancies in the United States, greater attention and effort should be aimed at preventing and identifying unwanted pregnancies that result from sexual victimization. (Am J Obstet Gynecol 1996;175:320-5.)

Relation of the content of prenatal care to the risk of low birth weight: Maternal reports of health behavior advice and initial prenatal care procedures

Objective. —Numerous studies have found a relationship between the quantity of prenatal care received and birth outcomes. Few studies have had the opportunity to examine the content of prenatal care. This study examined the relationship between two components of the content of prenatal care: maternal reports of health behavior advice received and initial prenatal care procedures performed during the first two visits and low birth weight in a national sample of women. Advice and initial procedures were categorized based on the recommendations of the US Public Health Service Expert Panel on the Content of Prenatal Care. Design. —Interview survey of a nationally representative sample of women who had live births in 1988. Participants. —A total of 9394 women, with data from the National Maternal and Infant Health Survey. Main Outcome Measure. —Low birth weight ( Results. —After controlling for other sociodemographic, utilization, medical, and behavioral factors, women who reported not receiving all the types of advice recommended by the Expert Panel on the Content of Prenatal Care were more likely to have a low—birth-weight infant compared with women who reported receiving the optimal level of advice (odds ratio=1.38; 95% confidence interval, 1.18 to 1.60). There were no differences between women who reported receiving all the recommended initial prenatal care procedures and those who reported not receiving all recommended prenatal care (odds ratio=1.00; 95% confidence interval, 0.87 to 1.14). Conclusion. —These data suggest that women who report receiving sufficient health behavior advice as part of their prenatal care are at lower risk of delivering a low—birth-weight infant. ( JAMA . 1994;271:1340-1345)

Relation of the Content of Prenatal Care to the Risk of Low Birth Weight

Numerous studies have found a relationship between the quantity of prenatal care received and birth outcomes. Few studies have had the opportunity to examine the content of prenatal care. This study examined the relationship between two components of the content of prenatal care: maternal reports of health behavior advice received and initial prenatal care procedures performed during the first two visits and low birth weight in a national sample of women. Advice and initial procedures were categorized based on the recommendations of the US Public Health Service Expert Panel on the Content of Prenatal Care. Interview survey of a nationally representative sample of women who had live births in 1988. A total of 9394 women, with data from the National Maternal and Infant Health Survey. Low birth weight (< 2500 g) as reported on the birth certificate. After controlling for other sociodemographic, utilization, medical, and behavioral factors, women who reported not receiving all the types of advice recommended by the Expert Panel on the Content of Prenatal Care were more likely to have a low-birth-weight infant compared with women who reported receiving the optimal level of advice (odds ratio = 1.38; 95% confidence interval, 1.18 to 1.60). There were no differences between women who reported receiving all the recommended initial prenatal care procedures and those who reported not receiving all recommended prenatal care (odds ratio = 1.00; 95% confidence interval, 0.87 to 1.14). These data suggest that women who report receiving sufficient health behavior advice as part of their prenatal care are at lower risk of delivering a low-birth-weight infant.

Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women.

Prevalence of crime and noncrime civilian traumatic events, lifetime posttraumatic stress disorder (PTSD), and PTSD in the past 6 months were assessed in a sample of U.S. adult women (N = 4,008). Random digit-dial telephone methods were used to identify study participants. Structured telephone interviews for assessment of specific crime or other traumatic event history and PTSD were conducted by trained female interviewers. Lifetime exposure to any type of traumatic event was 69%, whereas exposure to crimes that included sexual or aggravated assault or homicide of a close relative or friend occurred among 36%. Overall sample prevalence of PTSD was 12.3% lifetime and 4.6% within the past 6 months. The rate of PTSD was significantly higher among crime versus noncrime victims (25.8% vs. 9.4%). History of incidents that included direct threat to life or receipt of injury was a risk factor for PTSD. Findings are compared with data from other epidemiological studies. Results are discussed as they relate to PTSD etiology.

Peripheral leukocyte count and pulmonary function in a national sample of women and men.

The inverse relationship between peripheral leukocyte count and forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), previously reported in employed men, was investigated in women and men in a representative national sample. Leukocyte count was negatively correlated with FEV1 and FVC in most age, sex, and smoking subgroups in whites. In linear regression analyses controlling for age, height, and smoking variables, leukocyte count was significantly associated with FEV1 and FVC in white men (P < .05) and white women (P < .002). In "never smokers," significant independent associations were seen for leukocyte count and FVC in white men (P = .01) and FEV1 in white women (P = .02). These findings confirm an independent association of leukocyte count with pulmonary function in white men and extend the findings to white women.

Pulmonary function in histology technicians compared with women from Michigan: effects of chronic low dose formaldehyde exposure on a national sample of women.

Pulmonary function in histology technicians compared with women from Michigan: effects of chronic low dose formaldehyde exposure on a national sample of women.

Pulmonary function in histology technicians compared with women from Michigan: effects of chronic low dose formaldehyde on a national sample of women.

Chronic workplace exposure to formaldehyde and solvents at low doses reduced pulmonary function in 280 non-smoker white women working as histology technicians. They were studied during national workshops at four United States cities for four years. Height and age adjusted comparisons of pulmonary function were made with women in a stratified random population sample of Michigan and with a selected subset of the population that was used to model predictive pulmonary equations for function. The major functional change in histology technicians was a steeper decrement in vital capacity and flows from age 20 to 60 by regression analysis than occurred in the modelled Michigan population. Furthermore non-smoking and currently smoking women studied at two sites had significantly lower flows than were found in the sample of Michigan women. There was no consistent effect of an aerosol bronchodilator on flows of women at the four sites. Diffusing capacity for carbon monoxide single breath and alveolar volume were below the comparison group of Michigan women only when tested at Washington DC.